Immunoglobulin G4 Levels

Nagpal, Sajan Jiv Singh; Chari, Suresh T.

doi:10.1001/jama.2018.16665

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…72 Some studies have suggested that IgG4-RD represents a premalignant state or a paraneoplastic condition. [155][156][157][158][159] For example, Wallace et al 160 reported that a history of malignancy is 2.5-fold more likely in patients with IgG4-RD compared with the general U.S. population. The presence of malignancies was associated with older age, higher serum IgG4 concentration; no cases of IgG4-RD involved the organ previously affected by cancer.…”

Section: Prognosis and Follow-upmentioning

confidence: 99%

Thoracic Involvement in IgG4-Related Disease

Moura

Gripaldo

Baqir

et al. 2020

Semin Respir Crit Care Med

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Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder that has been recognized to involve virtually any organ in the body and typically manifests mass-like lesions (tumefactive). Although initial reports of this disease (autoimmune pancreatitis [AIP]) were described in the Japanese population, it has since been reported worldwide. It is most commonly seen in adults of middle age or older, more often men than women. The pathogenesis of IgG4-RD is largely unknown, but genetic factors, microorganisms, and autoimmunity are thought to play important roles. Serum IgG4 concentration is elevated in the majority of patients with IgG4-RD but is a nonspecific finding. Characteristic histopathologic features include dense lymphoplasmacytic infiltrate, fibrosis (often in storiform pattern), and obliterative phlebitis. Lung involvement in IgG4-RD was first reported in 2004 in two patients with AIP and coexisting interstitial lung disease. Since then, a wide spectrum of intrathoracic involvement has been reported and includes not only parenchymal lung diseases but also pleural, airway, vascular, and mediastinal lesions. Thoracic involvement in IgG4-RD is often found incidentally during the workup of extrathoracic lesions but can sometimes be the presenting abnormality. The diagnosis of IgG4-RD requires correlation of clinical, laboratory, imaging, and histopathologic features. Glucocorticoids are the first-line therapy but other options including B cell depletion are being investigated. IgG4-RD is generally associated with an indolent clinical course and most patients improve with glucocorticoid therapy.

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Section: Prognosis and Follow-upmentioning

confidence: 99%

Thoracic Involvement in IgG4-Related Disease

Moura

Gripaldo

Baqir

et al. 2020

Semin Respir Crit Care Med

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“…A diagnosis of AIP would require elevated IgG4 levels in addition to associated imaging features suggestive of AIP, which was not seen in this case. 10 Invasive procedures, such as fine-needle aspiration, have the potential to cause APdwith additional risks, including bleeding and infectiondand would be unlikely to change management.…”

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confidence: 99%

77-Year-Old Man With Nausea and Abdominal Pain

Choi

Kamboj

Pearson

2021

Mayo Clinic Proceedings

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77-year-old man presented with acute onset of right upperquadrant and epigastric abdominal pain over the past 10 hours. He described this as "aching," with radiation to the back. Associated symptoms included chills, nausea, and several episodes of nonbloody, nonbilious emesis.His medical history was notable for inflammatory ileocolonic Crohn disease status post ileocolonic resection, currently on budesonide; ankylosing spondylitis, on acetaminophen as needed; gastroesophageal reflux, on once-daily omeprazole; and latent tuberculosis, on isoniazid. Patient was previously on infliximab for several years as maintenance therapy for Crohn disease, with remission of symptoms, but this had recently been stopped around the time of initiation of isoniazid 9 months ago, when he was diagnosed with latent tuberculosis. Family history was negative for gastrointestinal disorders. He denied any past or current tobacco or alcohol use.At presentation, the patient's vital signs were as follows: temperature 36.8 C, heart rate 77 beats per minute, and blood pressure 96/59 mm Hg. Physical examination revealed epigastric tenderness to light palpation without peritoneal signs.Laboratory evaluation (reference range in parenthesis) yielded the following: hemoglobin 16.5 g/dL (13.0 to 17.0 g/dL); hematocrit 40% (40% to 50%) leukocytes 12.9 x 10 9 /L

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Update on Treatment of Idiopathic (and Non-Idiopathic) Orbital Inflammation

Meer,

Yoon,

2024

Curr Treat Options Neurol

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Immunoglobulin G4 Levels

Cited by 5 publications

References 12 publications

Thoracic Involvement in IgG4-Related Disease

Thoracic Involvement in IgG4-Related Disease

77-Year-Old Man With Nausea and Abdominal Pain

Update on Treatment of Idiopathic (and Non-Idiopathic) Orbital Inflammation

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